| NPI | 1962048728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE GIBSON Manager 216-716-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2023-03-06 |